How Much Does an X-Ray Cost? A Data Analysis of 300 U.S. Hospitals
Published May 2026 · Analysis of 300 hospitals across 47 states, CPT 71046 cash prices
A 2-view chest X-ray (CPT 71046) is posted at cash prices ranging from $20 to $2,976 across U.S. hospitals — a 149x gap for the identical test. The X-ray itself costs the hospital almost nothing; what you pay is overwhelmingly the facility fee, not the film.
An X-ray is one of the oldest, simplest, and cheapest tests in medicine. A chest film takes seconds, uses equipment that's been in every hospital for decades, and costs the facility very little to produce. So this analysis tells a different story than most of our pricing research: the absolute prices here are low. The median cash price for a 2-view chest X-ray is about $207, and the cheapest hospitals post it for $20. The headline isn't that X-rays are expensive — it's that the gap is enormous and almost entirely manufactured.
We pulled the cash (self-pay) prices that hospitals publish for three common X-ray codes under the federal Hospital Price Transparency Rule (45 CFR 180), across 300 hospitals in 47 states. For the same 2-view chest X-ray, one hospital charges $20 and another charges $2,976 — a 149x spread. That difference isn't the cost of a better picture. It's the facility fee, and it explodes when the X-ray is ordered in an emergency room. The good news for patients: because the floor is so low, a little shopping turns a four-figure bill into a two-figure one.
National X-Ray Cash Prices by Procedure
Cash-pay (self-pay) prices for three common X-ray codes, filtered to a $20–$4,000 plausibility window. Note how low the medians are — and how far the maximums stretch above them. Click a procedure to compare every hospital's price side by side.
| CPT | Procedure | Min | Median | Max | Hospitals |
|---|---|---|---|---|---|
| 71046 | Chest X-Ray (2 views) | $20 | $207 | $2,976 | 300 |
| 71045 | Chest X-Ray (1 view) | $20 | $171 | $1,859 | 295 |
| 73560 | Knee X-Ray | $20 | $186 | $3,351 | 295 |
Values below $20 were excluded as copay fragments, deposits, or single line-item component fees (13 hospitals posted such values). The wide gap between median and maximum on every row is the facility fee at work — see below.
The Transparency Paradox
The federal Hospital Price Transparency Rule took effect in 2021 to make hospital prices comparable. Five years on, a 2-view chest X-ray — the same CPT, 71046 — is posted at $20 at Sheridan Memorial Hospital in Sheridan, Wyoming and $2,976 at Belton Regional Medical Center in Belton, Missouri. That is a 149x gap for the identical test, published publicly by both hospitals under the same rule.
We call this the Transparency Paradox: the data is now public, but it didn't narrow what hospitals charge. If anything, an X-ray makes the paradox starker than a surgery does. A knee replacement is genuinely expensive to perform, so some of its spread reflects real differences in implants, staffing, and length of stay. A chest X-ray is not. The actual cost of producing the image is roughly the same at both hospitals — a few dollars of technologist time and equipment depreciation. A 149x gap on a test that costs almost nothing to perform isn't about cost at all. It's about how much facility fee each hospital decides to attach, and whether they can get away with charging it.
Why X-Ray Cost Varies So Much
- The facility fee dwarfs the actual imaging. This is the single biggest driver of the 149x spread. The radiation, the film, and a few minutes of a technologist's time are nearly identical everywhere. What differs is the hospital facility fee bolted on top — the charge for "using the building." At a $20 hospital that fee is essentially waived for self-pay X-rays; at a $2,976 hospital it's the entire bill.
- How many views. An X-ray's code depends on how many images are taken. A 1-view chest X-ray (CPT 71045) is the cheapest; a 2-view chest X-ray (CPT 71046) costs a bit more; a knee series (CPT 73560) is priced separately again. Confirm exactly which code your doctor ordered — a "chest X-ray" could be billed as one view or several.
- ER-ordered vs. outpatient. An X-ray taken in the emergency department is bundled with the ED facility fee, which on its own often runs $1,000–$3,000+. The same chest film that costs $50 at an outpatient clinic can effectively cost ten times more inside the ER simply because of the visit it's attached to. For a minor injury that isn't an emergency, where you get the X-ray matters far more than the X-ray itself.
- The radiologist's read is often a separate bill. The technical charge (taking the image) and the professional charge (a radiologist interpreting it) are frequently billed by two different entities. The posted "X-ray price" usually covers only the technical side, so the physician's read can add a second, smaller charge — and that physician group can be out of network even when the hospital is in network.
- Facility type and ownership. Large for-profit hospital systems post the highest X-ray prices; rural, community, and critical-access hospitals post the lowest. The most expensive facilities in our data are metro for-profit hospitals, while the $20 end is dominated by small rural hospitals.
- Freestanding and urgent-care imaging is cheaper. Our dataset covers hospitals, but a standalone urgent-care center or imaging clinic almost always charges less for the same X-ray than a hospital does, because it doesn't carry the hospital facility fee. For routine films, it's usually the cheapest door.
The 10 Most Expensive and 10 Cheapest Chest X-Rays
Posted cash prices for the 2-view chest X-ray (CPT 71046), one row per hospital (lowest posted cash price each). Click any hospital to see its full price and compare cash vs. gross vs. insurance-negotiated rates. Notice that the cheap end is a handful of dollars — this is a test where shopping genuinely pays off.
10 Most Expensive (CPT 71046)
| Hospital | Location | Cash Price |
|---|---|---|
| Belton Regional Medical Center | Belton, MO | $2,976 |
| Research Medical Center | Kansas City, MO | $2,670 |
| HCA Florida Twin Cities Hospital | Niceville, FL | $2,361 |
| Regional Medical Center of San Jose | San Jose, CA | $2,251 |
| Summit Medical Center | Casper, WY | $2,163 |
| HCA Florida Osceola Hospital | Kissimmee, FL | $2,134 |
| Sky Ridge Medical Center | Lone Tree, CO | $1,924 |
| HCA Florida JFK Hospital | Atlantis, FL | $1,869 |
| HCA Houston Healthcare Southeast | Pasadena, TX | $1,868 |
| Southern Hills Hospital and Medical Center | Las Vegas, NV | $1,859 |
10 Cheapest (CPT 71046)
| Hospital | Location | Cash Price |
|---|---|---|
| Sheridan Memorial Hospital | Sheridan, WY | $20 |
| National Jewish Health | Denver, CO | $20 |
| Boundary Community Hospital | Bonners Ferry, ID | $21 |
| Kearney Regional Medical Center | Kearney, NE | $21 |
| Pulaski Memorial Hospital | Winamac, IN | $21 |
| Edgefield County Healthcare | Edgefield, SC | $22 |
| North Country Hospital and Health Center | Newport, VT | $22 |
| Garfield County Memorial Hospital | Pomeroy, WA | $22 |
| Huron Regional Medical Center | Huron, SD | $22 |
| Neshoba County General Hospital | Philadelphia, MS | $24 |
The same 2-view chest X-ray costs 149x more at Belton Regional Medical Center ($2,976) than at Sheridan Memorial Hospital ($20) — and the image produced is identical. Remember that any of these figures may exclude the radiologist's separate professional fee for reading the film.
How to Pay Less for an X-Ray
- Ask for the cash or self-pay price up front. X-rays are cheap to produce, and the self-pay rate is often a small fraction of the billed charge. At many hospitals it's $20–$100. If you have insurance with a high deductible, compare the cash price against what you'd pay toward your deductible — the cash rate can be lower.
- Use urgent care or an outpatient clinic instead of the ER for minor injuries. If you don't have an emergency, an X-ray at urgent care or a freestanding imaging clinic avoids the ER facility fee that turns a $50 film into a four-figure bill. The ER is for emergencies; a sprained wrist on a Saturday usually isn't one.
- Confirm the number of views. The code — and the price — depends on how many images are taken. Ask exactly what your doctor ordered (1-view vs. 2-view, single body part vs. a series) so you can compare apples to apples.
- Ask whether the radiologist's read is included. The interpretation is often a separate, smaller bill from a separate physician group. Ask for an all-in price and whether that group is in your network.
- Get a written good-faith estimate. Under the No Surprises Act, self-pay and uninsured patients are entitled to a good-faith estimate before a scheduled service — useful even for something as routine as an X-ray.
What to Ask When You Schedule
- What is the CPT code, and how many views are being taken?
- What is the cash or self-pay price for this X-ray?
- Is the radiologist's read included, or billed separately by another group?
- Is there a facility fee on top of the X-ray charge?
- If this is in the ER, can I get the same X-ray at urgent care or outpatient instead?
- Can I get a written good-faith estimate of my total out-of-pocket cost?
Frequently Asked Questions
How much does an X-ray cost without insurance?
In our data, hospitals post cash prices for a 2-view chest X-ray (CPT 71046) ranging from $20 to $2,976, with a median of about $207. Most self-pay patients at a typical hospital pay somewhere between $100 and $400, and a small rural or community hospital may charge as little as $20–$50. The four-figure prices almost always reflect a hospital facility fee — and the highest of all come from X-rays taken in the emergency room, where the cost of the visit, not the film, drives the bill.
Why does a simple X-ray cost so much at some hospitals?
Because the price you're charged has almost nothing to do with the cost of the X-ray. The radiation, the film, and a few minutes of technologist time are nearly identical everywhere and cost the hospital very little. What varies is the facility fee — the charge for using the hospital — which some hospitals bolt on top and others waive for self-pay patients. That's why the same 2-view chest X-ray can be $20 at one hospital and nearly $3,000 at another: the gap is fee, not film.
Is an X-ray cheaper at urgent care than at the ER?
Almost always, and often dramatically so. An X-ray taken in the emergency department is bundled with the ED facility fee, which on its own commonly runs $1,000–$3,000 before the imaging is even counted. The same chest film at an urgent-care center or freestanding clinic skips that fee entirely and can cost a fraction as much. For a minor injury that isn't an emergency, urgent care or an outpatient clinic is the cheaper choice.
How many views are taken, and what determines the price?
An X-ray's billing code — and therefore its price — depends on how many images (views) are taken and of what body part. A 1-view chest X-ray (CPT 71045) is the cheapest; a 2-view chest X-ray (CPT 71046) costs a bit more; a knee series (CPT 73560) is a separate code again. Beyond views, the single biggest price factor is the facility fee the hospital attaches, which is why two hospitals can bill the same number of views at wildly different prices.
Is the radiologist's read a separate charge?
Often, yes. The X-ray bill is usually split into a technical charge (taking the image, billed by the hospital) and a professional charge (a radiologist interpreting it, frequently billed by a separate physician group). The posted X-ray price usually covers only the technical side, so the read can add a second, smaller charge — and that physician group can be out of network even when the hospital itself is in network. Always ask for an all-in price and whether the radiologist is in your network.
Does insurance cover X-rays?
Yes — medically necessary X-rays are covered by virtually all health plans, including Medicare and Medicaid, though you may owe a copay, coinsurance, or amount toward your deductible. If you have a high-deductible plan and haven't met the deductible, compare the hospital's cash price against your expected out-of-pocket cost: because X-rays are so cheap, paying the self-pay rate directly is sometimes less than running it through insurance.
Methodology
This analysis uses cash (self-pay) prices for three common X-ray codes — CPT 71046 (chest, 2 views), 71045 (chest, 1 view), and 73560 (knee) — from hospital Standard Charge files published under the CMS Hospital Price Transparency Rule (45 CFR 180). Where a hospital posts multiple cash rows for a code, we use its lowest. The figures reflect files available as of May 2026, across 300 hospitals in 47 states. We filter to a $20–$4,000 plausibility window.
Limitations
- Values below $20 were excluded (13 hospitals) as copay fragments, deposits, or single line-item component fees rather than a posted X-ray price.
- The posted price is typically the technical charge for the image only. The radiologist's professional fee for interpreting it is frequently a separate bill not reflected here.
- Our dataset covers hospitals, not freestanding urgent-care or imaging clinics, which usually charge less for the same X-ray — so the cheapest prices patients can find in practice are often lower than anything shown here.
- The highest figures often reflect a hospital facility fee, and the most expensive scenario of all — an X-ray bundled into an emergency-room visit — won't appear as a single X-ray line item at all.
- Cash prices apply to self-pay patients; an insured patient's negotiated rate may differ.
- Hospital reporting quality varies; some publish chargemaster (list) rates in the cash field.
References & Further Reading
- CMS Hospital Price Transparency Rule (45 CFR 180) — the federal requirement that produces the underlying data on this page.
- RadiologyInfo.org: X-Ray (Radiography) — patient guidance on what an X-ray is, how it's done, and what to expect.
- CMS: No Surprises Act — Good-Faith Estimates — your right to a written cost estimate before a scheduled service.
- American College of Radiology: ACR Appropriateness Criteria — evidence-based guidance on when an X-ray is clinically indicated.
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